On behalf of the American Society for Microbiology (ASM), we are writing to urge you to reject any efforts to impose Medicare beneficiary co-payments for laboratory testing. The ASM is the largest single life science society in the world with more than 42,000 members representing a broad spectrum of subspecialties, including microbiologists who work in clinical, public health, biomedical and industrial laboratories. The mission of ASM is to enhance the science of microbiology to better understand basic life processes and to promote the application of this knowledge for improved health and for economic and environmental well being. The contributions of our members are particularly important to patients who receive Medicare benefits, who may be disproportionately and adversely affected by the infectious and immunologic diseases, which ASM members seek to understand.

Co-payments could result in substantial and unwarranted cuts in payments to laboratories, in addition to the real reductions in payments that laboratories have experienced over the past fifteen years. Co-payments, for which administrative costs exceed the collectible amount, can negatively impact a laboratory's ability to continue to provide service to patients without incurring significant losses. The ASM is concerned that such reductions for laboratory testing may further jeopardize clinical and public health laboratory infrastructure, quality of work, and the ability to deliver clinically relevant services. Our nation's clinical and public health laboratories cannot continue to absorb further significant and disproportionate annual reductions.

Co-payment requirements could negatively affect patient care including the important connection between laboratory testing and the appropriate application and utilization of prescription therapies. Such results provide diagnostic information necessary for selection of medications as well as additional patient care options. For example, antimicrobial susceptibility testing provides a basis for antibiotic selection. Laboratory results also provide necessary monitoring of agents to prevent unnecessary toxicity.

The ASM firmly believes that the results of the Institute of Medicine (IOM) Study on Methods for Laboratory Reimbursement under Medicare Part B should be completed and made available before considering reductions to laboratory testing. The IOM study will include a review of the adequacy of the current methodology and recommendations regarding alternative payment systems. The study will also analyze and discuss the relationship between such payment systems and access to high quality laboratory tests for patients who receive Medicare benefits, including availability and access to new testing methodologies.

We urge the Finance Committee to consider the potential negative impact of proposed reimbursement reduction strategies on laboratory medicine, which in turn, will affect patient care as a whole. Such reductions may lead to a decrease in laboratory quality during a time of increasing threats from emerging infectious diseases, antimicrobial resistance, and bioterrorism. The ASM looks forward to working with you to support quality health care in the United States. Thank you for your consideration of these issues, and we would be pleased to provide additional information or assistance.